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Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis?
Diagnosis of de novo autoimmune hepatitis (AIH) after orthotopic liver transplantation (OLT) is challenging especially in the absence of hyper-γ-globulinemia. Circulating autoantibodies are not sensitive nor specific in de novo AIH but when positive increase the diagnostic probability. We report the...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723963/ https://www.ncbi.nlm.nih.gov/pubmed/29279846 http://dx.doi.org/10.1155/2017/3563278 |
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author | Clemente, Maria Grazia Antonucci, Roberto Mandato, Claudia Cicotto, Lucia Meloni, Antonella Gridelli, Bruno De Virgiliis, Stefano Manns, Michael P. Vajro, Pietro |
author_facet | Clemente, Maria Grazia Antonucci, Roberto Mandato, Claudia Cicotto, Lucia Meloni, Antonella Gridelli, Bruno De Virgiliis, Stefano Manns, Michael P. Vajro, Pietro |
author_sort | Clemente, Maria Grazia |
collection | PubMed |
description | Diagnosis of de novo autoimmune hepatitis (AIH) after orthotopic liver transplantation (OLT) is challenging especially in the absence of hyper-γ-globulinemia. Circulating autoantibodies are not sensitive nor specific in de novo AIH but when positive increase the diagnostic probability. We report the discovery of novel liver microsomal (LM) autoantibodies against CYP-2C19 in a 9-year-old boy with “de novo” AIH developed 7 years after OLT. Graft dysfunction presented with hypertransaminasemia (up to 400 IU/L), while serum γ-globulins remained within the normal range for age. Liver histology and response to high dose prednisone (2 mg/kg/day) with the addition of azathioprine therapy further supported the diagnosis of de novo AIH. Autoantibodies investigation by indirect immunofluorescence (IF) on rodent tissues showed a novel staining pattern involving the pericentral liver zone and sparing the renal tissue. Human but not rat liver proteins immunoblotting allowed us to characterize the novel LM antibodies and to identify CYP-2C19 as human antigen. The finding offers insights into the controversial discussion about autoimmunity versus alloreactivity with regard to the pathogenesis of de novo AIH. Correct information on human versus rat tissue antigens tested by methods other than IF for antibodies detection may have significant implications for the correct diagnosis and management of patients followed up after OLT. |
format | Online Article Text |
id | pubmed-5723963 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-57239632017-12-26 Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? Clemente, Maria Grazia Antonucci, Roberto Mandato, Claudia Cicotto, Lucia Meloni, Antonella Gridelli, Bruno De Virgiliis, Stefano Manns, Michael P. Vajro, Pietro Biomed Res Int Research Article Diagnosis of de novo autoimmune hepatitis (AIH) after orthotopic liver transplantation (OLT) is challenging especially in the absence of hyper-γ-globulinemia. Circulating autoantibodies are not sensitive nor specific in de novo AIH but when positive increase the diagnostic probability. We report the discovery of novel liver microsomal (LM) autoantibodies against CYP-2C19 in a 9-year-old boy with “de novo” AIH developed 7 years after OLT. Graft dysfunction presented with hypertransaminasemia (up to 400 IU/L), while serum γ-globulins remained within the normal range for age. Liver histology and response to high dose prednisone (2 mg/kg/day) with the addition of azathioprine therapy further supported the diagnosis of de novo AIH. Autoantibodies investigation by indirect immunofluorescence (IF) on rodent tissues showed a novel staining pattern involving the pericentral liver zone and sparing the renal tissue. Human but not rat liver proteins immunoblotting allowed us to characterize the novel LM antibodies and to identify CYP-2C19 as human antigen. The finding offers insights into the controversial discussion about autoimmunity versus alloreactivity with regard to the pathogenesis of de novo AIH. Correct information on human versus rat tissue antigens tested by methods other than IF for antibodies detection may have significant implications for the correct diagnosis and management of patients followed up after OLT. Hindawi 2017 2017-11-27 /pmc/articles/PMC5723963/ /pubmed/29279846 http://dx.doi.org/10.1155/2017/3563278 Text en Copyright © 2017 Maria Grazia Clemente et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Clemente, Maria Grazia Antonucci, Roberto Mandato, Claudia Cicotto, Lucia Meloni, Antonella Gridelli, Bruno De Virgiliis, Stefano Manns, Michael P. Vajro, Pietro Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? |
title | Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? |
title_full | Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? |
title_fullStr | Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? |
title_full_unstemmed | Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? |
title_short | Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis? |
title_sort | autoantibodies against cyp-2c19: a novel serum marker in pediatric de novo autoimmune hepatitis? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723963/ https://www.ncbi.nlm.nih.gov/pubmed/29279846 http://dx.doi.org/10.1155/2017/3563278 |
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